Provider Demographics
NPI:1215583794
Name:LUMPKINS, JAMES HARRY JR (LMT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:HARRY
Last Name:LUMPKINS
Suffix:JR
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5350 OLD HIGHWAY 11E
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-1055
Mailing Address - Country:US
Mailing Address - Phone:423-258-8035
Mailing Address - Fax:
Practice Address - Street 1:2629 W AJ HWY STE 120
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3387
Practice Address - Country:US
Practice Address - Phone:423-258-8035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10925225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist